Browse Guides  internal medicine  gastroenterology

Upper gastrointestinal bleed

Prevalence
Causes
Clinical features
Investigations
Therapy
Prevention
Prognosis
Therapy

Order an endoscopy a  to make a diagnosis and determine future risk of bleeding or death (using the Rockall score - see prognosis) a

Look out for endoscopic stigmata of recent haemorrhage a

    • blood in upper GI tract
    • an adherent clot
    • a visible or spurting vessel
Why?
  • Malignancy increases the risk of dying or rebleeding; a Mallory-Weiss tear or a normal examination make both less likely a
  • Endoscopic stigmata increase the risk of dying or rebleeding a
    • blood in upper GI tract
    • adherent clot
    • visible or spurting vessel

Expiry date: July 2003
Levels of Evidence used in grading these guides

Author   A   Townsend , CM   Ball
Reviewer   L   Friedman
CAT Writers   A   Townsend , CM   Ball , CJ   Wotton